#16,986
Over the past few hours Argentine media have been reporting that the unidentified pneumonia in Tucumán Province, Argentina is due to Legionella - but it has only been in the past half hour that the local MOH has confirmed those reports.
Legionella had reportedly been ruled out, but there are nearly 5 dozen different recognized Legionella species (although only about half are known to cause human illness), and probably some we have yet to discover
So despite earlier negative tests, it has never really been off the table.
Yesterday, in PAHO Statement On Argentina's Unidentified Pneumonia Outbreak, we discussed the possibility that the unidentified pneumonia outbreak at a private clinic in Tucumán Province might stem from an environmental bacterial pathogen - like Legionella or Elizabethkingia - instead of a virus.
The (translated) announcement from the MOH follows:
Vizzotti confirmed that the outbreak of pneumonia in Tucumán was due to legionella
From Government House, the Minister of Health of the Nation, together with her counterpart from the province, Dr. Luis Medina Ruiz, confirmed that it is an outbreak of legionella, possibly pneumophila.
With the presence of the Minister of Health of the Nation, Carla Vizzotti , and the representative in Argentina of the Pan American Health Organization (PAHO), Eva Jané Llopis, this Saturday from the province's health portfolio confirmed that the samples taken from patients affected by bilateral pneumonia tested positive for legionella bacteria.
Vizzotti explained at a press conference that, until now, they have preliminary information and there is still progress to be made in the final diagnosis, which is with serological pairs, however "in four samples (three respiratory and a puncture biopsy of one of the deceased) it is being isolated in the PCR a bacterium called legionella and its surname is being typified and will be there today," he said, adding: "The suspicion is that it is an outbreak of legionella pneumophila."
The Minister of Health commented that it is a bacterium that is transmitted by inhalation through water or air conditioning. It has an antibiotic treatment and a significant impact on people at risk, older than 50 years, smokers, diabetics and people with immunocompromise or respiratory diseases.
All the actions are being generated and the recommendation that we agree with the provincial team is that, having the diagnosis and that it is safe to transfer these patients to another hospital to follow their evolution, to be able to generate an exhaustive study of the health center and thus carry out the actions in the building both in the water and in the air conditioning system so that it is completely safe to return to work in such a health center”, said Vizzotti.
For his part, the Minister of Public Health, Dr. Luis Medina Ruiz , highlighted the joint work with the Nation and contextualized stating that since last Saturday, when they became aware of two patients with bilateral pneumonia who were not with a known etiology of the 30 studies that can be developed in Tucumán and that they came from the same place of work, "it caught our attention and we began to work in the active search for patients who meet the same conditions and we found six".
"So it was that on Monday we checked that it was neither Covid-19 nor flu nor hantavirus, and on Tuesday we made the decision to make this new epidemic situation known and we generated a contingency plan together with the Nation to evaluate the etiology," he explained.
Along these lines, he continued: “We developed a patient control strategy, we decided on the sanitary isolation of the private sanatorium and we sent samples to the National Institute of Microbiology Dr. Malbrán and the National Institute of Human Viral Diseases «Dr. Julio I. Maiztegui».
Finally, the representative of the Pan American Health Organization, Dr. Eva Jane Llopis , valued the speed and efficiency with which these cases were worked on both in the province and in the Nation. “This demonstrates an optimal way to identify the problem and respond, in addition to notifying the world in a timely manner, through the mechanism of international health regulations. There you can see the commitment of Tucumán and Argentina to global public health and I think this is very important”, she emphasized.
Some past blogs on Legionella include:
NYC DOH Statement On Legionnaire's Disease Outbreak In Queens
NEJM: Probable Person-to-Person Transmission Of Legionnaires’ Disease
ECDC: Rapid Risk Assessment On Portugal’s Legionnaire’s Disease Outbreak
When news of this outbreak broke 3 days ago, I opened my first blog on the topic with the following caveat:
`Mystery' disease outbreaks are reported fairly often around the globe each year - particularly from remote regions with limited medical resources - and while initially mysterious, most turn out to caused by something relatively common (e.g., Malaria, Dengue, Influenza, Measles, alcohol poisoning, etc.).
Of course, every once in awhile, something new - or at least unexpected - is the cause.
Right now it appears that we've gotten lucky with this outbreak, and that it is something we understand and know how to treat. It is a tragedy for those involved, but it doesn't constitute another global threat.
But there are undoubtedly more formidable pathogens out there, just waiting for the right opportunity to emerge, and we need to be prepared to meet them when they do.
